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General NPI Number Information
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NPI Number | 1003123613
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Entity Type | Organization
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Legal Business Name | STEPHEN & ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 7863 BROADWAY STE 115
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5564
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Country | US
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Telephone | 219-613-9050
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Fax | 219-794-1226
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Provider Business Mailing Address
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Address Line | 7863 BROADWAY STE 115
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5564
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Country | US
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Telephone | 219-613-9050
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Fax | 219-794-1226
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Authorized Official
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Title or Position | MARRIAGE & FAMILY THERAPIST
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Name | ROY THOMAS
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Credential | LCSW
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Telephone | 219-613-2122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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